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自发性脾破裂:疟疾与登革热合并感染的罕见并发症——一例报告

Spontaneous splenic rupture: A rare complication of concurrent malaria and dengue infections - A case report.

作者信息

Moumin Hassan Elmi, Ali Abdirahman Omer, Egge Ahmed Abdi Aw, Abdi Mohamoud Hashi, Moumin Abdillahi Elmi, Muse Abdisalam Hassan

机构信息

College of Health Sciences, School of Medicine and Surgery, Amoud University, Borama, Somalia; Borama Regional Hospital, Surgery Department, Somalia.

College of Health Sciences, School of Medicine and Surgery, Amoud University, Borama, Somalia; School of Postgraduate Studies and Research, Amoud University, Amoud Valley, Borama 25263, Somalia.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110783. doi: 10.1016/j.ijscr.2024.110783. Epub 2024 Dec 27.

Abstract

INTRODUCTION

Spontaneous splenic rupture (SSR) is a rare, life-threatening complication, sometimes associated with infections like malaria and dengue fever. This case report details a unique presentation of SSR.

CASE PRESENTATION

A 28-year-old male in Somalia presented with fever, epigastric pain, nausea, vomiting, and body aches, consistent with malaria and dengue. Following self-discharge after initial malaria treatment, his condition deteriorated rapidly, leading to severe abdominal pain and hypotension. Laboratory tests confirmed malaria and dengue, with low hemoglobin. A CT scan revealed a large hemoperitoneum and splenic rupture requiring emergency laparotomy and splenectomy. Post-operative recovery was uneventful.

DISCUSSION

This case highlights the diagnostic challenges posed by overlapping symptoms of malaria and dengue, potentially masking SSR. The concurrent infections likely contributed to splenomegaly, increasing rupture risk. While SSR has been linked to malaria or dengue individually, this case suggests a potential synergistic effect of co-infection. The patient's self-discharge emphasizes the importance of patient education and treatment adherence. Successful surgical intervention underscores the critical role of prompt medical care.

CONCLUSION

This is the first reported case of SSR secondary to concurrent Plasmodium falciparum malaria and dengue fever in Somalia. This highlights the need for improved diagnostic tools, healthcare infrastructure, and targeted public health interventions in endemic regions. Further research is crucial to understand the synergistic effect of these co-infections in inducing SSR.

摘要

引言

自发性脾破裂(SSR)是一种罕见的、危及生命的并发症,有时与疟疾和登革热等感染有关。本病例报告详细介绍了SSR的一种独特表现。

病例介绍

一名28岁的索马里男性出现发热、上腹部疼痛、恶心、呕吐和身体疼痛,符合疟疾和登革热症状。在最初的疟疾治疗后自行出院,其病情迅速恶化,导致严重腹痛和低血压。实验室检查确诊为疟疾和登革热,血红蛋白水平低。CT扫描显示大量腹腔积血和脾破裂,需要紧急剖腹手术和脾切除术。术后恢复顺利。

讨论

本病例突出了疟疾和登革热重叠症状带来的诊断挑战,可能掩盖了SSR。同时感染可能导致脾肿大,增加破裂风险。虽然SSR已分别与疟疾或登革热相关联,但本病例提示了合并感染可能存在协同效应。患者自行出院强调了患者教育和治疗依从性的重要性。成功的手术干预突出了及时医疗护理的关键作用。

结论

这是索马里首例报告的继发于恶性疟原虫疟疾和登革热同时感染的SSR病例。这突出表明在流行地区需要改进诊断工具、医疗基础设施和有针对性的公共卫生干预措施。进一步的研究对于了解这些合并感染在诱发SSR中的协同效应至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d87/11743890/a902d110659b/gr1.jpg

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